Michael Dong1, Linda Liu2, Kenneth C Bilchick3, Nishaki K Mehta4, Yoon-Sik Cho5, Ryan J Koene6, Selcuk Adabag7, Adrian Baranchuk8, Neal A Chatterjee9, T Jared Bunch10, Hirad Yarmohammadi11, Younghoon Kwon12,13. 1. Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA. 2. Department of Medicine, University of Washington, Seattle, WA, USA. 3. Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, USA. 4. Department of Cardiovascular Medicine, William Beaumont Oakland University School of Medicine, Rochester, MI, USA. 5. Division of Cardiology, Chung-Ang University, Seoul, South Korea. 6. Aultman Deuble Heart and Vascular Hospital, Canton, OH, USA. 7. Division of Cardiology, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA. 8. Division of Cardiology, Department of Medicine, Queen's University, Kingston, ON, Canada. 9. Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA. 10. Department of Internal Medicine, Intermountain Healthcare, Salt Lake City, UT, USA. 11. Division of Cardiology, Department of Medicine, Columbia University, New York City, NY, USA. 12. Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA. yhkwon@cardiology.washington.edu. 13. Harborview Medical Center, Division of Cardiology, University of Washington, 325 9th Avenue, Box 359748, Seattle, WA, 98104-2499, USA. yhkwon@cardiology.washington.edu.
Abstract
PURPOSE: Obstructive sleep apnea syndrome (OSAS) is an important, modifiable risk factor in the pathophysiology of arrhythmias including atrial fibrillation (AF). The purpose of the study was to evaluate cardiac electrophysiologists' (EPs) perception of OSAS. METHODS: We designed a 27-item online Likert scale-based survey instrument entailing several domains: (1) relevance of OSAS in EP practice, (2) OSAS screening and diagnosis, (3) perception on treatments for OSAS, (4) opinion on the OSAS care model. The survey was distributed to 89 academic EP programs in the USA and Canada. While the survey instrument questions refer to the term sleep apnea (SA), our discussion of the diagnosis, management, and research on the sleep disorder is more accurately described with the term OSAS. RESULTS: A total of 105 cardiac electrophysiologists from 49 institutions responded over a 9-month period. The majority of respondents agreed that sleep apnea (SA) is a major concern in their practice (94%). However, 42% reported insufficient education on SA during training. Many (58%) agreed that they would be comfortable managing SA themselves with proper training and education and 66% agreed cardiac electrophysiologists should become more involved in management. Half of EPs (53%) were not satisfied with the sleep specialist referral process. Additionally, a majority (86%) agreed that trained advanced practice providers should be able to assess and manage SA. Time constraints, lack of knowledge, and the referral process are identified as major barriers to EPs becoming more involved in SA care. CONCLUSIONS: We found that OSAS is widely recognized as a major concern for EP. However, incorporation of OSAS care in training and routine practice lags. Barriers to increased involvement include time constraints and education. This study can serve as an impetus for innovation in the cardiology OSAS care model.
PURPOSE: Obstructive sleep apnea syndrome (OSAS) is an important, modifiable risk factor in the pathophysiology of arrhythmias including atrial fibrillation (AF). The purpose of the study was to evaluate cardiac electrophysiologists' (EPs) perception of OSAS. METHODS: We designed a 27-item online Likert scale-based survey instrument entailing several domains: (1) relevance of OSAS in EP practice, (2) OSAS screening and diagnosis, (3) perception on treatments for OSAS, (4) opinion on the OSAS care model. The survey was distributed to 89 academic EP programs in the USA and Canada. While the survey instrument questions refer to the term sleep apnea (SA), our discussion of the diagnosis, management, and research on the sleep disorder is more accurately described with the term OSAS. RESULTS: A total of 105 cardiac electrophysiologists from 49 institutions responded over a 9-month period. The majority of respondents agreed that sleep apnea (SA) is a major concern in their practice (94%). However, 42% reported insufficient education on SA during training. Many (58%) agreed that they would be comfortable managing SA themselves with proper training and education and 66% agreed cardiac electrophysiologists should become more involved in management. Half of EPs (53%) were not satisfied with the sleep specialist referral process. Additionally, a majority (86%) agreed that trained advanced practice providers should be able to assess and manage SA. Time constraints, lack of knowledge, and the referral process are identified as major barriers to EPs becoming more involved in SA care. CONCLUSIONS: We found that OSAS is widely recognized as a major concern for EP. However, incorporation of OSAS care in training and routine practice lags. Barriers to increased involvement include time constraints and education. This study can serve as an impetus for innovation in the cardiology OSAS care model.
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